Recent Advances in the Management of Severe Gastrointestinal Dysmotility

[Meleber]

Abstract

Severe gastrointestinal motility disorders with small bowel involvement continue to pose a major clinical challenge to clinicians, particularly because of the limitations of diagnostic tests and the lack of efficacious treatment options.

In this article, we review current understanding and the utility of diagnostic modalities and therapeutic approaches, and describe how their limitations may potentially exacerbate prolonged suffering with debilitating symptoms, diagnostic delays, the risk of iatrogenic harm and increased healthcare utilisation in this group of patients.

Moreover, observations from intestinal failure units worldwide suggest that this problem could be set to increase in the future, with reported trends of increasing numbers of patients presenting with nutritional consequences.

Unfortunately, until recently, there has been a lack of consensus recommendations and guidance to support clinicians with their management approach.

The aim of this narrative review is to summarise recent developments in this field following publication of an international census of experts, and subsequent clinical guidelines, which have emphasized the importance of holistic, multidisciplinary care. This is particularly important in achieving good clinical outcomes and ensuring the appropriate use of artificial nutritional support, in order to prevent iatrogenic harm.

We discuss how these recent developments may impact clinical practice by supporting the development of specialised clinical services to deliver optimal care, and highlight areas where further research is needed.

Source: ncbi.nlm.nih.gov/pmc/articl...

[Luisa22]

"Moreover, observations from intestinal failure units worldwide suggest that this problem could be set to increase in the future, with reported trends of increasing numbers of patients presenting with nutritional consequences. "

It's rather disturbing to hear gut dysmotility must be on the increase and is expected to get worse! I wonder what is happening?

[Meleber in reply to Luisa22]

Maybe it's because there's an increasing clinical awareness for dysmotility as underlying cause for gastrointestinal disorders leading to a higher amount of patients reported?

So we as patients were always there but now are being examined more thoroughly, the clinicians are now looking / listening better?

Not in my case (in the Netherlands) however. Yes, the gastroenterologist I did see do agree I have a gastrointestinal disorder but weren't able to find the underlying cause yet.

That's why I asked for a second/third opinion in a tertiary hospital in Belgium. I have a first consult mids August this year because of a suspected dysmotility problem, chronic intestinal pseudo-obstruction (CIPO, formerly CIIP).